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Notably, the interest in treating inflammation in patients suffering acute myocardial infarction (AMI) is now expanding from its chronic aspects to the acute setting. Few large outcome trials have proven the benefits of anti-inflammatory therapies on cardiovascular outcomes by targeting the residual inflammatory risk (RIR), i.e. the smouldering ember of low-grade inflammation persisting in the late phase after AMI. However, these studies have also taught us about potential risks of anti-inflammatory therapy after AMI, particularly related to impaired host defence. Recently, numerous smaller-scale trials have addressed the concept of targeting a deleterious flare of excessive inflammation in the early phase after AMI. Targeting different pathways and implementing various treatment regimens, those trials have met with varied degrees of success. Promising results have come from those studies intervening early on the interleukin-1 and -6 pathways. Taking lessons from such past research may inform an optimized approach to target post-AMI inflammation, tailored to spare \u2018The Good\u2019 (repair and defence) while treating \u2018The Bad\u2019 (smouldering RIR) and capturing \u2018The Ugly\u2019 (flaming early burst of excess inflammation in the acute phase). Key constituents of such a strategy may read as follows: select patients with large pro-inflammatory burden (i.e. large AMI); initiate treatment early (e.g. \u226412 h post-AMI); implement a precisely targeted anti-inflammatory agent; follow through with a tapering treatment regimen. This approach warrants testing in rigorous clinical trials.<\/jats:p>","DOI":"10.1093\/eurheartj\/ehad486","type":"journal-article","created":{"date-parts":[[2023,7,19]],"date-time":"2023-07-19T12:29:27Z","timestamp":1689769767000},"page":"89-103","source":"Crossref","is-referenced-by-count":379,"title":["Inflammation in acute myocardial infarction: the good, the bad and the ugly"],"prefix":"10.1093","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-1905-5586","authenticated-orcid":false,"given":"Michael A","family":"Matter","sequence":"first","affiliation":[{"name":"Department of Cardiology, University Heart Center, University Hospital Zurich , R\u00e4mistrasse 100, 8091 Zurich , Switzerland"},{"name":"Center for Translational and Experimental Cardiology (CTEC), Department of Cardiology, Zurich University Hospital and University of Zurich , R\u00e4mistrasse 100, 8091 Zurich , Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6483-7844","authenticated-orcid":false,"given":"Francesco","family":"Paneni","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Heart Center, University Hospital Zurich , R\u00e4mistrasse 100, 8091 Zurich , Switzerland"},{"name":"Center for Translational and Experimental Cardiology (CTEC), Department of Cardiology, Zurich University Hospital and University of Zurich , R\u00e4mistrasse 100, 8091 Zurich , Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1502-502X","authenticated-orcid":false,"given":"Peter","family":"Libby","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine, Brigham and Women\u2019s Hospital , 75 Francis Street, Boston, MA 02115, USA"},{"name":"Harvard Medical School , 25 Shattuck Street, Boston, MA 02115 , 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Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3863-8766","authenticated-orcid":false,"given":"Thomas M","family":"K\u00fcndig","sequence":"additional","affiliation":[{"name":"Department of Dermatology, University Hospital Zurich , R\u00e4mistrasse 100, 8091 Zurich , Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0824-3026","authenticated-orcid":false,"given":"Lorenz","family":"R\u00e4ber","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Bern University Hospital, Inselspital , Freiburgstrasse 18, 3010 Bern , Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5972-0596","authenticated-orcid":false,"given":"Frank","family":"Ruschitzka","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Heart Center, University Hospital Zurich , R\u00e4mistrasse 100, 8091 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